Infectious Disease
Major depressive episodes following COVID-19 illness differ from the typical appearance
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Disclosure:
Perlis reports that it has received consulting fees from Burrage Capital, Genomind, RID Ventures and Takeda; Receiving personal fees from Belle Artificial Intelligence; and participation in Outermost Therapeutics and Psy Therapeutics. The other authors do not report any relevant financial information.
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Apparent major depressive episodes after contracting COVID-19 appeared to be different from those normally seen in adults, according to the results of a survey in a research letter published on JAMA Network Open.
“The rates of severe depressive symptoms are increased after an acute infection with SARS-CoV-2” Roy H. Perlis, MD, MSc, of the Department of Psychiatry at Massachusetts General Hospital and colleagues. “A key question is whether such symptoms represent a general consequence of stress related to an acute illness or whether they reflect more specific consequences related to the COVID-19 pathophysiology itself. To investigate this possibility, in this survey we compared the characteristics of major depression in people with and without a previous COVID-19 illness.
Infographic data derived from: Perlis RH, et al. JAMA network open. 2021; doi: 10.1001 / jamanetworkopen.2021.16612.
The researchers used a commercial multi-panel provider to conduct 12 waves of Qualtrics’ Internet non-likelihood survey among people aged 18 or older approximately every month between May 2020 and February 2021. They included sociodemographic questions related to gender, income, age, education, urbanity, and self-identified race / ethnicity according to five U.S. census categories with the aim of incorporating race and ethnicity to determine how these and other sociodemographic factors played a role in the responses play COVID-19 disease and quarantine. The participants indicated whether and when, according to their medical diagnosis, they had COVID-19 disease or whether they had a positive SARS-CoV-2 test result. They completed Patient Health Questionnaire-9 (PHQ-9) to measure depressive symptoms, with at least moderate symptoms defined with a score of 10 or higher. The logistic regression with moderate or severe depressive symptoms served as the dependent variable and socio-demographic characteristics as the independent variables. Perlis and colleagues compared the means for each symptom of depression and anxiety between participants with or without prior COVID-19. They also rated the prevalence of depressive symptoms by months that have passed since COVID-19.
A total of 91,791 people completed the PHQ-9. Of these participants, 67% were female, 10.5% black, 7.3% Hispanic American, 5.8% Asian, 40.1% had a college degree, 24.2% were urban, and 17.6% were rural. Participants had an average age of 42.34 years and an average annual income of $ 49,000. In addition, 6.5% reported a previous COVID-19 clinic diagnosis or test result, and 31.2% reported moderate or severe depressive symptoms. Regression models for depressive symptoms showed significant associations between previous COVID-19 status and gender, income, black vs. white race, and urban vs. rural setting. Perlis and colleagues observed the largest differences in PHQ-9 scores for individual symptoms in those with or without prior COVID-19 for suicidality and motor symptoms. The risk of depressive symptoms increased with longer duration with each additional month after an acute illness.
“By and large, our results may indicate a different disease process in at least a subset of individuals,” wrote Perlis and colleagues. “At the very least, these differences suggest that there is a need to better understand the differences and similarities between post-COVID-19 depressive symptoms and those associated with a typical major depressive disorder.”
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